Association between waist-to-height ratio and endothelial dysfunction in patients with morbidity ― A report from the FMD-J study

Akihiro Tokushige, Shinichiro Ueda, Hirofumi Tomiyama, Mituru Ohishi, Takahide Kohro, Yukihito Higashi, Bonpei Takase, Toru Suzuki, Tomoko Ishizu, Tsutomu Yamazaki, Tomoo Furumoto, Kazuomi Kario, Teruo Inoue, Shinji Koba, Yasuhiko Takemoto, Takuzo Hano, Masataka Sata, Yutaka Ishibashi, Koichi Node, Koji Maemura & 4 others Yusuke Ohya, Taiji Furukawa, Hiroshi Itoh, Akira Yamashina

Research output: Contribution to journalArticle

Abstract

Background: Waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI) are known as easy anthropometric markers of abnormal obesity and screening tools for predicting cardiovascular outcomes, but which indices are best is unclear. We therefore investigated the superiority and association between each index and low flow-mediated dilatation (FMD) as a surrogate marker for cardiovascular outcomes in patients with morbidity in a large Japanese prospective cohort. Methods and Results: A total of 1,645 Japanese patients who had coronary artery disease and hypertension or diabetes mellitus were enrolled, and 1,087 of them were analyzed. The high-WHtR group (≥0.5) showed greater morbidity and increased inflammation in association with atherosclerosis compared with the low-WHtR group. High WHtR and advanced age were identified as predictors of low FMD (odds ratio (OR) 1.39, 95% confidence interval (CI) 1.02–1.88, P=0.037 and OR 1.55, 95% CI 1.19–2.01, P=0.001, respectively). However, WC was not associated with that risk in either sex (male: OR 1.37, 95% CI 0.97–1.93, P=0.076; female: OR 1.08, 95% CI 0.68–1.73, P=0.74), and no association was evident between high BMI and low FMD (OR 0.92, 95% CI 0.71–1.19, P=0.54). Conclusions: WHtR offers a superior predictor of decreased FMD than other anthropometric indices, and progression of arteriosclerosis might be detected more sensitively. Further study is needed to investigate the relationship between cardiovascular mortality and WHtR.

Original languageEnglish
Pages (from-to)1911-1918
Number of pages8
JournalCirculation Journal
Volume81
Issue number12
DOIs
Publication statusPublished - Jan 1 2017

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Dilatation
Morbidity
Odds Ratio
Confidence Intervals
Waist Circumference
Body Mass Index
Arteriosclerosis
Waist-Height Ratio
Coronary Artery Disease
Atherosclerosis
Diabetes Mellitus
Obesity
Biomarkers
Hypertension
Inflammation
Mortality

Keywords

  • Body mass index
  • Endothelial dysfunction
  • Flow-mediated vasodilatation
  • Waist circumference
  • Waist-to-height ratio

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Association between waist-to-height ratio and endothelial dysfunction in patients with morbidity ― A report from the FMD-J study. / Tokushige, Akihiro; Ueda, Shinichiro; Tomiyama, Hirofumi; Ohishi, Mituru; Kohro, Takahide; Higashi, Yukihito; Takase, Bonpei; Suzuki, Toru; Ishizu, Tomoko; Yamazaki, Tsutomu; Furumoto, Tomoo; Kario, Kazuomi; Inoue, Teruo; Koba, Shinji; Takemoto, Yasuhiko; Hano, Takuzo; Sata, Masataka; Ishibashi, Yutaka; Node, Koichi; Maemura, Koji; Ohya, Yusuke; Furukawa, Taiji; Itoh, Hiroshi; Yamashina, Akira.

In: Circulation Journal, Vol. 81, No. 12, 01.01.2017, p. 1911-1918.

Research output: Contribution to journalArticle

Tokushige, A, Ueda, S, Tomiyama, H, Ohishi, M, Kohro, T, Higashi, Y, Takase, B, Suzuki, T, Ishizu, T, Yamazaki, T, Furumoto, T, Kario, K, Inoue, T, Koba, S, Takemoto, Y, Hano, T, Sata, M, Ishibashi, Y, Node, K, Maemura, K, Ohya, Y, Furukawa, T, Itoh, H & Yamashina, A 2017, 'Association between waist-to-height ratio and endothelial dysfunction in patients with morbidity ― A report from the FMD-J study', Circulation Journal, vol. 81, no. 12, pp. 1911-1918. https://doi.org/10.1253/circj.CJ-17-0211
Tokushige, Akihiro ; Ueda, Shinichiro ; Tomiyama, Hirofumi ; Ohishi, Mituru ; Kohro, Takahide ; Higashi, Yukihito ; Takase, Bonpei ; Suzuki, Toru ; Ishizu, Tomoko ; Yamazaki, Tsutomu ; Furumoto, Tomoo ; Kario, Kazuomi ; Inoue, Teruo ; Koba, Shinji ; Takemoto, Yasuhiko ; Hano, Takuzo ; Sata, Masataka ; Ishibashi, Yutaka ; Node, Koichi ; Maemura, Koji ; Ohya, Yusuke ; Furukawa, Taiji ; Itoh, Hiroshi ; Yamashina, Akira. / Association between waist-to-height ratio and endothelial dysfunction in patients with morbidity ― A report from the FMD-J study. In: Circulation Journal. 2017 ; Vol. 81, No. 12. pp. 1911-1918.
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abstract = "Background: Waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI) are known as easy anthropometric markers of abnormal obesity and screening tools for predicting cardiovascular outcomes, but which indices are best is unclear. We therefore investigated the superiority and association between each index and low flow-mediated dilatation (FMD) as a surrogate marker for cardiovascular outcomes in patients with morbidity in a large Japanese prospective cohort. Methods and Results: A total of 1,645 Japanese patients who had coronary artery disease and hypertension or diabetes mellitus were enrolled, and 1,087 of them were analyzed. The high-WHtR group (≥0.5) showed greater morbidity and increased inflammation in association with atherosclerosis compared with the low-WHtR group. High WHtR and advanced age were identified as predictors of low FMD (odds ratio (OR) 1.39, 95{\%} confidence interval (CI) 1.02–1.88, P=0.037 and OR 1.55, 95{\%} CI 1.19–2.01, P=0.001, respectively). However, WC was not associated with that risk in either sex (male: OR 1.37, 95{\%} CI 0.97–1.93, P=0.076; female: OR 1.08, 95{\%} CI 0.68–1.73, P=0.74), and no association was evident between high BMI and low FMD (OR 0.92, 95{\%} CI 0.71–1.19, P=0.54). Conclusions: WHtR offers a superior predictor of decreased FMD than other anthropometric indices, and progression of arteriosclerosis might be detected more sensitively. Further study is needed to investigate the relationship between cardiovascular mortality and WHtR.",
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T1 - Association between waist-to-height ratio and endothelial dysfunction in patients with morbidity ― A report from the FMD-J study

AU - Tokushige, Akihiro

AU - Ueda, Shinichiro

AU - Tomiyama, Hirofumi

AU - Ohishi, Mituru

AU - Kohro, Takahide

AU - Higashi, Yukihito

AU - Takase, Bonpei

AU - Suzuki, Toru

AU - Ishizu, Tomoko

AU - Yamazaki, Tsutomu

AU - Furumoto, Tomoo

AU - Kario, Kazuomi

AU - Inoue, Teruo

AU - Koba, Shinji

AU - Takemoto, Yasuhiko

AU - Hano, Takuzo

AU - Sata, Masataka

AU - Ishibashi, Yutaka

AU - Node, Koichi

AU - Maemura, Koji

AU - Ohya, Yusuke

AU - Furukawa, Taiji

AU - Itoh, Hiroshi

AU - Yamashina, Akira

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: Waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI) are known as easy anthropometric markers of abnormal obesity and screening tools for predicting cardiovascular outcomes, but which indices are best is unclear. We therefore investigated the superiority and association between each index and low flow-mediated dilatation (FMD) as a surrogate marker for cardiovascular outcomes in patients with morbidity in a large Japanese prospective cohort. Methods and Results: A total of 1,645 Japanese patients who had coronary artery disease and hypertension or diabetes mellitus were enrolled, and 1,087 of them were analyzed. The high-WHtR group (≥0.5) showed greater morbidity and increased inflammation in association with atherosclerosis compared with the low-WHtR group. High WHtR and advanced age were identified as predictors of low FMD (odds ratio (OR) 1.39, 95% confidence interval (CI) 1.02–1.88, P=0.037 and OR 1.55, 95% CI 1.19–2.01, P=0.001, respectively). However, WC was not associated with that risk in either sex (male: OR 1.37, 95% CI 0.97–1.93, P=0.076; female: OR 1.08, 95% CI 0.68–1.73, P=0.74), and no association was evident between high BMI and low FMD (OR 0.92, 95% CI 0.71–1.19, P=0.54). Conclusions: WHtR offers a superior predictor of decreased FMD than other anthropometric indices, and progression of arteriosclerosis might be detected more sensitively. Further study is needed to investigate the relationship between cardiovascular mortality and WHtR.

AB - Background: Waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI) are known as easy anthropometric markers of abnormal obesity and screening tools for predicting cardiovascular outcomes, but which indices are best is unclear. We therefore investigated the superiority and association between each index and low flow-mediated dilatation (FMD) as a surrogate marker for cardiovascular outcomes in patients with morbidity in a large Japanese prospective cohort. Methods and Results: A total of 1,645 Japanese patients who had coronary artery disease and hypertension or diabetes mellitus were enrolled, and 1,087 of them were analyzed. The high-WHtR group (≥0.5) showed greater morbidity and increased inflammation in association with atherosclerosis compared with the low-WHtR group. High WHtR and advanced age were identified as predictors of low FMD (odds ratio (OR) 1.39, 95% confidence interval (CI) 1.02–1.88, P=0.037 and OR 1.55, 95% CI 1.19–2.01, P=0.001, respectively). However, WC was not associated with that risk in either sex (male: OR 1.37, 95% CI 0.97–1.93, P=0.076; female: OR 1.08, 95% CI 0.68–1.73, P=0.74), and no association was evident between high BMI and low FMD (OR 0.92, 95% CI 0.71–1.19, P=0.54). Conclusions: WHtR offers a superior predictor of decreased FMD than other anthropometric indices, and progression of arteriosclerosis might be detected more sensitively. Further study is needed to investigate the relationship between cardiovascular mortality and WHtR.

KW - Body mass index

KW - Endothelial dysfunction

KW - Flow-mediated vasodilatation

KW - Waist circumference

KW - Waist-to-height ratio

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